Clin Oral Impl Res. 2018;29:339–345. wileyonlinelibrary.com/journal/clr
© 2018 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd
1 | INTRODUCTION
Sinus augmentation procedures are used to augment the bone volume
when placing dental implants in the pneumatized posterior maxilla
(Boyne & James, 1980; Pjetursson, Thoma, Jung, Zwahlen, & Zembic,
2012). These techniques can be broadly categorized into two lateral
and crestal types according to the bone grafting approach. As its in-
troduction by Boyne and James, the lateral approach of sinus augmen-
tation procedure has been suggested at sites with a ridge height of
<5 mm (Jensen & Terheyden, 2009). The sinus augmentation proce-
dure involving a lateral approach can provide a direct surgical view
when detaching the sinus membrane and also allow the appropriate
use of instruments directly.
Accepted: 9 December 2017
Report of a human autopsy case in maxillary sinuses
augmented using a synthetic bone substitute: Micro- computed
tomographic and histologic observations
* | Jae-Kook Cha
* | Daniel S. Thoma
| Ui-Won Jung
*These authors contributed equally to this work.
Department of Periodontology, Research
Institute for Periodontal Regeneration, College
of Dentistry, Yonsei University, Seoul, South
Department of Fixed and Removable
Prosthodontics and Dental Material
Science, Dental School, University of Zurich,
Ui-Won Jung, Department of Periodontology,
Research Institute for Periodontal
Regeneration, College of Dentistry, Yonsei
University, Seoul, South Korea.
This work was supported by the National
Research Foundation of Korea (NRF) grant
funded by the Korean government (Ministry
of Science, ICT & Future Planning) (No. NRF-
Objective: This study of a human autopsy case aimed to characterize the histologic
and micro- computed tomographic results of maxillary sinus augmentation using a
synthetic bone substitute and simultaneous implant placement at 6 years.
Material and methods: This report is based on the whole- body donation of a
62- year- old male patient who died due to bladder cancer. Implants had been placed in
conjunction with sinus augmentation using a mixture of biphasic calcium phosphate
and autogenous bone into both maxillary sinuses 6 years prior to the body donation.
The maxillary sinus areas containing implants were gently removed from the cadaver
and scanned using high- resolution micro- computed tomography. Samples were sec-
tioned, prepared for undecalcified histologic slides and stained with
Results: The augmented volume was observed up to the apex of the implants, which
were successfully osseointegrated. Cross- sectional micro- computed tomographic
views revealed that the bone- substitute particles were embedded in radiopaque-
mineralized tissues showing a trabecular pattern around the implants. The histologic
analysis revealed mature lamellar bone surrounding the remaining bone- substitute
particles as well as well- organized bone marrow spaces in the augment bone area and
around the dental implants.
Conclusion: This human autopsy study histologically confirmed the presence of suc-
cessful bone formation and long- term volume stability after sinus augmentation using
biphasic calcium phosphate and simultaneous implant placement.
bone substitute, case report, dental implants, histomorphology, sinus augmentation